| Organization Name: | A.R.BHAGWANDASS.DMD.PA |
| NPI Number: | 1104012269 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANISHWAR R BHAGWANDASS (PRESIDENT) |
| Mailing Address: | 50 Anna Louise Ln Roanoke Rapids |
| State: | NC US |
| Postal Code: | 278708648 |
| Phone Number: | 2525374141 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2007 |
| NPI Last Update Date: | 09/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 5794 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |